Researchers and doctors gear up for the healthcare of the future

Man and machine must increasingly interact to make diagnoses and treat illness. Here, an MRI is being performed at Uppsala University Hospital.

Photograph: Johan Alp

In Uppsala, the university and hospital are building a common centre for technological innovations and faster implementation of tools in a healthcare system that is facing ever-greater challenges.

“The modern, highly specialised healthcare sector is becoming more and more technical,” says Sune Larsson, Professor and Director of Research at Uppsala University Hospital. “Man and machine must increasingly interact to make diagnoses and treat illness. This means that, in addition to healthcare professionals, we also need advanced technical expertise comprising both technology for use in hospitals and solutions that make it possible to provide care remotely.”
The university city can boast a successful tradition in this field. A number of important advances have originated here, such as the modern pregnancy test and the micromechanical sensor used in cardiac diagnosis. One of the factors behind this success is the close tie between research, healthcare and industry, and another arena for medical technology development is now being built.

“The tools we create must meet current needs, but at present it takes an average of 17 years before an innovation actually benefits patients. We are confident that the process can be considerably streamlined through knowledge and cooperation,” says Fredrik Nikolajeff, Director of Medtech Science & Innovation, the new collaborative venture between Uppsala University and Uppsala University Hospital.
The venture, which was launched in June, brings together the University’s Faculty of Science and Technology and Faculty of Medicine, and in collaboration with Region Uppsala, the researchers who will form the core of operations are now being recruited. The aim is to have everything up and running by 2018.
“The timing could hardly be better,” says Nikolajeff. “Healthcare is in the midst of a paradigm shift in which costs must be cut and methods streamlined, and the need for digital processes and new tools is becoming increasingly obvious. An arena is thus needed where healthcare professionals and researchers can meet, needs can be translated into innovations, and prototypes can be demonstrated. We will be moving into premises on the hospital grounds in the spring, but on 29 November, we are launching a seminar series that we hope will contribute to the creation of a common forum.”

Initially, the research centre will conduct research in four strategically selected areas. In the 2018 autumn semester, operations will be expanded with a three-year university engineering programme focusing on medical technology. The syllabus is ready and space has been prepared for 30 students.
“The programme is an investment in the future,” says Nikolajeff, “but even now, medical technology research at Uppsala University has a turnover of several hundred million kronor. There are a number of interesting and successful projects, and after a careful strengths and needs assessment, we have decided to focus on radiation therapy in oncology, medical sensor technology and computer-assisted surgery.”
Yet the fourth pillar, accelerating the implementation of new technology in healthcare, is the niche that makes this venture unique. But is it really possible to chart a straight course through stringent rules, evidence requirements and high development costs?
“It is a complex challenge of course,” says Nikolajeff, “but by identifying thresholds and patterns, we want to contribute to eventually streamlining the process. We are also discussing the possibility of following and assisting the implementation of a specific innovation. If we can help get a product out into healthcare in eight years, it would be an important confirmation that our goals can be achieved.”

At Uppsala University Hospital, there is a lot of enthusiasm about gathering forces in the new centre. Magnus Larsson, newly appointed Digitalisation Manager, describes the tearing down of walls as a prerequisite for the development and establishment of new processes, and this requires a meeting place where knowledge and experience can be exchanged.
Placing the centre’s physical residence on hospital premises is therefore viewed as a central factor for success, as it will both make it easier for physicians to access the centre and help researchers get a clearer picture of healthcare activities.
“We want to create an environment that builds context,” says Nikolajeff, “and that will prioritise functional spaces and high availability right from the start. With time, we hope that awareness of the centre and the advancements we contribute to will spread, and that in five years we will be running a vibrant research centre where intellectual exchange and interaction form a model for increased cooperation between the University’s Faculty of Medicine and Faculty of Science and Technology.”

Martin Wohlin, Senior Lecturer in Emergency Care, heads the development of a new IT system in which
care recipients report and assess their own symptoms. PHOTO: MIKAEL WALLERSTEDT

The development of new technology certainly hasn’t come to a standstill while waiting for the new research centre to open its doors, though. At the Department of Medical Sciences premises near the entrance to Uppsala University Hospital, work is in full swing to create tools that will increase both patient participation and the quality of care.
“Healthcare needs to be digitalised quickly, and with good tools that meet the needs of both staff and patients, says Martin Wohlin, Senior Lecturer in Emergency Care at Uppsala University, who is leading the development of a new IT system in which the care recipients report and evaluate their own symptoms.
An early version has already been tested in the University Hospital’s emergency ward and the reactions of patients who tested the solution were very positive.
“‘How are you?’ is probably the most common question healthcare professionals ask,” says Wohlin, “but we misunderstand and don’t store the responses. With our technique, patients can, for example, assess their pain before they even meet the doctor. This increases their involvement, streamlines care and provides good decision support for investigation, treatment and follow-up.”

The ability to measure the value and quality of care is another key effect of the project. Time per visit and number of operations performed have long been typical benchmarks, but there is a pronounced need both within and outside the healthcare organisation to be able to monitor and evaluate the actual impact of the performed interventions.
“Healthcare is extremely expensive,” says Wohlin, “but with bad IT systems, it costs even more. We need to ensure that our tax money generates maximum patient benefit, and in this, the health progress of the care recipients is a key variable. If the patients evaluate and report their symptoms continuously, we can follow the changes, see how the care is working and use artificial intelligence to identify patterns and make diagnoses.”

The tool has the potential to
help many patients.

With financial support from Region Uppsala, among others, and working under the motto “simplicity, usability and value”, the eleven-person team aims to launch the system in 2018. Thus far, patients with gastrointestinal diseases and fibromyalgia have participated in the process, but the goal is to develop a general tool that can be used by everyone, regardless of diagnosis.
“The need for improved digital tools is being stressed everywhere,” says Wohlin, “and our system can create decision support and the opportunity to remotely monitor the patient’s progress. Several of the country’s healthcare regions have already reported their interest in contributing to the development. Going forward, we will include language options, which will enable an international launch, so I believe this tool has the potential to help an infinite number of patients.”

Uppsala gears up for the future. Since 2016, the region has been one of the nodes in Medtech4Health, Vinnova’s strategic innovation programme which includes Medtech Science & Innovation. The programme acts as a catalyst to strengthen the medical technology industry and implement new technologies in healthcare. A strong belief in human-centred interaction is also prevalent here.
“The development of digital healthcare is ninety per cent about activities and ten per cent about things,” says Magnus Larsson, Digitalisation Manager at Uppsala University Hospital. “That is why we are now creating a platform, based on our roles and working methods, which can define the results we need to achieve and what processes are required. We can then more precisely determine how future equipment should be designed to give us the conditions to improve the patient’s journey, the staff’s workday and the integration of research into healthcare. For me, this is nothing strange, but simply the next step in the continuous development that has been taking place since computers first made their entrance in healthcare.”